Year: 2014
Type: dissertation
Abstract: Over half a century, there have been significant improvements in mental health outcomes particularly in individuals with psychosis.This is due to understanding and advances in psychological therapies e.g Cognitive Behaviour Therapy (CBT) and psychotropic medication.These studies have been based on outcomes that focus on symptoms and general functioning and the predominant nature of these studies has been quantitative.Patient movements have criticised these studies due to no effort being made to include their views.In order to get a better understanding of patients' experiences of CBT for psychosis (CBTp) in secure services, it is important to gather their views of 'supportive and non supportive work' including the views of the treating professionals.This will help to develop a qualitative foundation, rich of their experiences, which may help to form the base of a manual.This thesis is divided into three studies and used both qualitative and quantitative methods.The first study looks to explore the experiences and views of patients and professionals in secure settings.This study used sequential method of grounded theories e.g.thematic analysis, approach looking from a social constructivists view, to explore both patients' and professionals' views of what is supportive in CBTp in secure services.In total there were 33 professionals and 17 patients from two sites who were interviewed about their experiences in providing and receiving therapy.Professionals provided rich data on various aspects of therapy and patients narrated their experiences of therapy, medication and being held in secure services.Patients provided their views of what is supportive and non supportive in CBTp including other psychological therapies and factors which may effect their work with professionals.Following the first study, the findings of the grounded theory led to the development of a model and themes that formed the basis of a CBTp manual in the second study.This intervention was based on the work on Kingdon & Turkington (2005) guidance, but adapted for delivery in a one to one work.This study adopted a pilot Randomised Controlled Trial (RCT) and eight patients received newly adapted CBT treatment and four patients were in control group who received Treatment As Usual (TAU).Patients who received the new CBT intervention achieved improvements in their psychotic, negative symptoms; social functioning, anger and insight.To further consolidate qualitative data from study one and two and gather patients' views of the new CBT intervention, study three was carried out.This study employed qualitative work and analysed patients views using thematic analysis.Patients provided their views of what works in CBTp and factors that are important to consider when working with patients in secure services, which allowed further adaptation to the new CBT guidance manual.The findings of all three studies are further discussed with the limitations and implications for clinical practice and research.
Author: Gurmit Dhillon
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2120031500